Comparison of healthcare utilization and life-sustaining interventions between patients with glioblastoma receiving palliative care or not: A population-based study

Abstract

Background: Palliative care has historically been under-utilized in patients with glioblastoma. Furthermore, literature on the utilization of healthcare and life-sustaining interventions during the late-stage of glioblastoma has been limited. Aim: To identify and compare healthcare utilization and life-sustaining interventions between patients with glioblastoma who received palliative care and who did not based on patients identified retrospectively from Taiwan Cancer Registry between January 2007 and December 2017. Design: In this study, palliative care was defined on the basis of claims submitted to the National Health Insurance, which has a specific code for it. Variables included demographic characteristics, the utilization of healthcare services, and invasive life-sustaining interventions. Setting/participants: Of the 1994 patients with glioblastoma identified, 1784 fulfilled the inclusion criteria, 613 (34%) of whom received palliative care. Results: The survival of patients with glioblastoma under palliative care was significantly longer than that of those without palliative care. Those without palliative care had significantly more frequent intensive care unit admissions and a longer cumulative length of intensive care unit stay. Regarding cardiopulmonary or respiratory treatments, patients without palliative care had significantly more invasive interventions than those with palliative care. Patients receiving palliative care had significantly lower odds than those without life-sustaining interventions. Conclusions: Our retrospective analysis reveals that glioblastoma patients without palliative care had greater odds of receiving life-sustaining treatments within 1 year before their death, although no gains in survival as compared to those that received palliative care. These findings highlight the urgent need for palliative care in caring for patients with glioblastoma.

Rehabilitation in People Living with Glioblastoma: A Narrative Review of the Literature

“…The authors reported that 34% of patients received palliative care. They further found that the survival of these patients who did receive palliative care was significantly longer than that of those who did not receive palliative care [71]. The results of this retrospective study need to be treated with caution, as individuals who live longer would have had more time to have palliative care services organized, which might explain why they received palliative care more often.…”

“…Despite both the European Association of Neuro-Oncology (EANO) [3] and the National Institute for Health and Clinical Excellence (NICE) [69] recommending early referral to palliative and supportive care services, the actual provision of such care to people with primary brain tumors is scarce [70]. Recently, Shieh et al [71] conducted a large population-based retrospective analysis (n = 1994) of the utilization of palliative care in patients with glioblastoma in Taiwan over a period of ten years. The authors reported that 34% of patients received palliative care.…”

Palliative care and neuro-oncological care: Better integration is needed

“…In the other paper, Shieh et al compared healthcare utilization and life-sustaining interventions between patients with glioblastoma who received palliative care and who did not receive palliative care, based on patients identified retrospectively from the Taiwan Cancer Registry. 3 They found, amongst others that patients with glioblastoma who received palliative care had longer survival although less frequently invasive interventions were given. They also found that only about 34% of patients with glioblastoma were referred to palliative care within 1 year of death, based on claims submitted to the National Health Insurance.…”